Patient selection: HIV-associated pneumocystis pneumonia
Outcome: death
Parameters on admission:
(1) age in years
(2) history of previous episode of PJP
(3) evidence of pulmonary Kaposi sarcoma (PKS)
(4) medical comorbidity (non-Hodgkin's lymphoma, psychosis, neurological disease, disseminated cryptococcosis, disseminated histoplasmosis, chronic substance abuse, sepsis, heart failure, cardiomyopathy, chronic respiratory disease, thrombo-embolic disease, tuberculosis, Castleman diseease, hypothyroidism, acute renal failure, viral hepatitis, cachexia, pregnancy, etc)
(5) PaO2 in kPa on room air
(6) hemoglobin in g/dL
|
Parameter
|
Finding
|
Points
|
|
age in years
|
|
(age)/10
|
|
history of PJP
|
No
|
0
|
|
|
Yes
|
2
|
|
pulmonary Kaposi sarcoma
|
Absent
|
0
|
|
|
Present
|
4
|
|
comorbidity
|
Absent
|
0
|
|
|
Present
|
3
|
|
PaO2
|
|
(-1) * (PaO2)
|
|
hemoglobin
|
|
(-1) * (hemoglobin)
|
total score =
= SUM(points for all 6 parameters) + 25.5
Interpretation:
• The higher the score the greater the risk of mortality.
|
Score
|
Group
|
Mortality Rate
|
|
< 4.0
|
1
|
0%
|
|
4.0 to 7.9
|
2
|
3%
|
|
8.0 to 10.9
|
3
|
9%
|
|
11.0 to 14.9
|
4
|
29%
|
|
>= 15.0
|
5
|
52%
|
